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Surgeon: Pre-loaded injection system makes cataract surgery easier and safer
The Premier injector is pre-loaded with the Corneal ACR6D SE implant, but other IOL models will soon be available in Europe.
The Premier pre-loaded, single-use injector manufactured by Corneal is a safe, easy-to-use and innovative system for IOL implantation, according to Christophe Poirier, MD.
“Being pre-loaded, the implant is completely sterile and it is delivered to the eye in perfectly aseptic conditions. There’s no contact with the lens during the procedure, and this eliminates the risk of contamination with bacteria or foreign bodies such as talc, dust or blood,” he said.
The Premier injector is pre-loaded with the Corneal ACR6D SE IOL, but other implants, such as the Corneal Svelio, will soon be available with the same system, he said. These IOLs and the injector are not available or approved for use in the United States.
Easy to use
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“Using the Premier system is easy,” Dr. Poirier said. The pre-loaded injector is packaged in a sterile container. He said that, after lifting the gasket and emptying the liquid from the container, the surgeon takes out the injector and presses the lever onto the central body of the device until complete blockage is accomplished.
“This maneuver automatically folds the lens and prepares it for implantation. With a gentle pressure on the plunger, the surgeon pushes the lens forward into the injection cannula and checks the ‘Side Up’ inscription visible on the surface of the central body. Then, the tip of the cannula is inserted slightly into the incision, and a light, steady pressure on the plunger delivers the lens into the anterior segment,” Dr. Poirier explained.
The implant unfolds in a steady, controlled manner, he said. Once introduction of the first haptic is achieved, the second haptic can be positioned by gentle rotation with forceps. Finally, the viscoelastic is removed and the surgeon checks that the lens is correctly placed at the capsular bag equator.
Dr. Poirier said the learning curve for using the Premier system is short and fast.
“Once you have gotten used to it, it is honestly difficult to get back to traditional injectors, with all the cleaning, sterilizing, assembling, folding, filling and loading that they involve,” he said. “Since it requires so little handling and precautions, you can concentrate on other aspects of surgery, and neither you nor your assistants need to spend time on pre-surgical preparation.”
No deposits on optic surface
Dr. Poirier contributed to the development and progressive improvement of the Premier system until its introduction to the market in April 2004. Since May 2004, he has used the system in his daily practice, implanting more than 500 ACR6D SE IOLs.
“Premier is a safe, reproducible system. I have never observed tears, notches or scratches on the implant. The most remarkable aspect is the absence of deposits on the lens optic, which are often caused by the lubricating substances used with traditional injectors. All the inside parts of the Premier system receive a special surface treatment, which assures a perfect sliding of the implant and avoids formation of deposits on the posterior surface of the optic,” he pointed out.
“The ACR6D SE IOL is a good implant, well known for its optical qualities, for centration and stability in the bag and remarkable refractive outcomes,” he said. It is a one-piece hydrophilic acrylic lens with an optic diameter of 6 mm and a total diameter of 12 mm. The square-edge design ensures protection against posterior capsule opacification, he said.
“This particular lens can be injected through an incision of 3 mm or even less if the orifice of the cannula is positioned right in front of the corneal incision,” Dr. Poirier said.
Future developments of the Premier system and the use of other IOL models will allow implantation through incisions of less than 2 mm, he said.
For Your Information:
- Christophe Poirier, MD, can be reached at Polyclinique de l’Atlantique, La Rochelle, or Polyclinique Pasteur, Royan, France; e-mail: christophe.poirier@wanadoo.fr or christophe.poirier7@wanadoo.fr.
- Michela Cimberle is an OSN Correspondent based in Asolo, Italy.